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ACCESS TO CARE
The Mixed Blessings of Combat Nursing Assignments
Major Mary C. Quinn, ANC
In the midst of deployments and ominous discussions of further action in Southwest Asia, the Army Nurse Corps will celebrate its 102nd Anniversary. On 2 February 1901, the Army Nurse Corps was founded as a distinct yet integral branch of the Army and its medical department. As Army Nurse Corps Officers, we have an obligation to connect with our history. Our history is testimony to what the Army Nurse Corps has done and to what we do every day. History provides present day Army Nurse Corps Officers with a framework. The experiences and lessons of our predecessors guide our present day actions. History is truly our link to understanding the past, defining the present and influencing our future. The current focus on deployments encourages a look at past operations that the Army Nurse Corps has supported. The following excerpt, written in 1968, is taken from an orientation letter sent to nurses preparing to deploy to Vietnam. Major Mary C. Quinn, Chief Nurse, 71st Evacuation Hospital, Pleiku, Vietnam, writes in hopes of inspiring the young nurses that will soon staff her hospital. Almost 35 years later, present day military nurses can distinguish countless parallels. This is the value that history offers.
The following words are part of the orientation presented to newly arrived Army Nurse Corps Officers at the 71st Evacuation Hospital. They consist of thoughts, observations, and suggestions gleaned from the many fine nurses who have served on the nursing staff of this installation. Perhaps they will have some meaning for other nurses in country. Perhaps too, they may serve to stimulate others to take pen in hand and share the fruits of knowledge available at each unique medical facility spread throughout this land of South Vietnam.
Nursing in a combat area has many unusual features - some good - some bad. The philosophy of nursing you bring with you will have a lot to do with how this year in the Republic of Vietnam will affect you. You cannot come to your DEROS the same individual you were on the day you arrived in country. You will be either a better or worse nurse--a better or worse person. The outcome will depend primarily upon yourself.
Let us look at some of the plus signs for personal and professional growth and development. One of the biggest blessings encountered over here is that the American soldier who comes under your care is the most wonderful patient in the world. His ability to accept the misfortune that brings him to the hospital and to continue to be combative against the forces of pain, infection, disfigurement and frustrating helplessness is phenomenal. More remarkable, however, is the fact that he will try to make you feel you are "the greatest" because you care for him in his hour of need. That you do care, really care, for him not only as a patient but as a person is essential if your work is to remain meaningful and satisfying. If you should cease to care you become crippled personally and professionally. It is, then, essential that you do not allow work routines to become monotonous and rob you of this great opportunity to practice the fine "art" of nursing at every bedside day or night.
Another facet of life here in South Vietnam is the realization of how much stamina you possess. Long hours, tense days and nights, heavy workloads and close day-to-day contact test your mettle and the moment of reckoning must be faced by all.
After the two incidents at this hospital when the dangers of war invaded our compound in the form of exploding 122mm enemy rockets, the most heart warming lesson learned by many was that the concern for the patients was uppermost in their minds even with "bombs bursting in air." The heroic actions of the men and women on the wards during those terrible moments saved the lives of more than one patient confined to bed and incapable of helping himself. The call "Nurse" brought instant response. Some people were very surprised and, of course, very pleased to realize they had acted so calmly and efficiently under stress. It was a good feeling!
The unusual and sometimes awesome task of handling mass casualty situations not just once but time and time again sharpens your ability to organize the available resources and to improve all your nursing skills. With experience comes the knack of differentiating between the routine case and the urgent case. The wound of entrance may appear deceivingly minimal to the uninitiated. The need for careful scrutiny and constant attention to vital signs soon becomes second nature to the combat nurse.
War in Vietnam is not only bloody wounds and broken bones. It is also a battle against diseases such as malaria and hepatitis. You as the nurse can be a lifesaver for the patient who develops the insidious symptoms of cerebral malaria. You must be alert to the clinical manifestations warning of this dangerous complication. Your astute observations, carefully recorded and related to the medical officer, are of the utmost importance if treatment is to be of any avail.
The opportunity to take an active part in medical and nursing research is always just around the corner if you are willing to look in that direction. The wealth of material available for those who have the urge to write for publication is tremendous. A little perseverance and encouragement from friends and neighbors goes a long way.
Interest in Civic Action Programs among the local population also provides an outlet for satisfying professional and personal growth. Even though limited in many respects, the little that can be done in teaching and guiding Vietnamese and Montagnard students in the fundamentals of care of the sick and wounded is a worthwhile undertaking. Many times you may be hampered in this work by enemy activity, curfews or disinterest among the people you would like to help. By doing what you can, when you can, you will leave something worthwhile behind you when your tour is up.
You may find yourself developing ambivalent feelings about the patient load as the weeks and months progress. If the hospital is busy the time passes faster and after a hard day's work you can go to your hootch tired but with the feeling you are needed and being here is really necessary and worthwhile. However, this means men are facing the enemy in frightful conflict and for some, release from battle will only come with death. If the wards are quiet time drags, boredom sets in and tempers grow short but then you are aware that during these quiet times there is a respite from the fighting and people are not being brutally wounded or killed.
Now, when those 365 "short" days are completed and you come to that long awaited DEROS it is hoped you will be able to look back and be satisfied that you:
Mary C. Quinn began her military career in 1950 as a general duty nurse at Fitzsimmons General Hospital in Denver, Colorado. She served in Korea with the 8055th MASH from February 1951 until May 1952. After multiple assignments that took her to Germany, Japan and many stateside posts, she served in South Vietnam from June 1967 until August 1968. She retired from active duty at the rank of Colonel in November 1976. Col (R) Quinn, after 26 years as an Army Nurse Corps Officer, believes that nursing in a combat zone hospital can never be forgotten. At a memorial ceremony honoring military nurses in Weymouth, Massachusetts in November 1987, COL Quinn stated, "The nurse must be armed to fight just as the soldier, sailor, or marine. The nurse's weapons are knowledge and skills that can be employed to wage war on disease and injury wherever these calamities have laid low a man, woman, or child."
As we celebrate our 102nd Anniversary and prepare for an uncertain future, take a moment to capture strength and inspiration from the rich heritage that the Army Nurse Corps proudly embraces. Army Nurses: Ready, Caring and Proud.
Historical Data located at the Army Nurse Corps Archives, United States Army, Office of Medical History, Office of The Surgeon General, Falls Church, VA